As much as I love working in the NICU and caring for my preemies, I think it is more important for YOU to learn how to help avoid us NICU providers. Yes, premature births are on the rise. Working as a bedside neonatal nurse, I can attest to this statement and confirm first hand how prevalent this is becoming. However, this is not a time to fret! In fact, I think this is a time to EMPOWER you! The more knowledge and education the better! I am so happy to confidently share with you some things that I have learned from my experience throughout the years that may help you along your way. I hope to give you some insight into how to hopefully prevent a premature birth (or NICU admission) and provide some useful tips in your own pregnancy!
LET'S START FROM THE BEGINNING
A pregnancy normally lasts about 40 weeks. Important growth and development happen throughout pregnancy, but it’s ESPECIALLY important in the final weeks and months. Preterm birth occurs for a variety of reasons. Most preterm births happen spontaneously, but some are due to early induction of labor or cesarean delivery. A premature birth is a birth that takes place more than three weeks before the baby's estimated due date (before the 37th week of pregnancy). Premature babies, especially those born very early, often have complicated medical problems and complex health issues. There are three subcategories of premature birth, each based on gestational age:
Extremely preterm (less than 28 weeks)
Very preterm (28 to 32 weeks)
Moderate to late preterm (32 to 37 weeks).
PREVENTING PREMATURE BIRTH
Preventing preterm birth remains a challenge because there are SO many causes of preterm birth. These causes may be complex, spontaneous, idiopathic, and not always well understood. It’s unfortunate because we don't exactly know why this happens. However, there are some predetermining factors and important steps every pregnant woman can take to help reduce her risk of preterm birth and improve her general health and wellbeing:
1. Get healthy BEFORE your pregnancy!
This one is a bit obvious.
2. Prenatal care
Prior to trying to conceive, check in with your OBGYN first! Visiting your doc can help to shed some light on changes you may need to do prior to pregnancy.
3. Take a Prenatal Vitamin
One of the most essential ingredients of a PNV is Folic Acid, with a recommended dose being 400 mcg. Folic Acid is essential for developing the fetal brain & spinal cord. These develop within the first 10 weeks of conception... oftentimes when you don't even know you’re pregnant! Taking a PNV prior to pregnancy can help prevent neural tube defects such as spina bifida, anencephaly, encephalocele, and other various issues.
4. Lifestyle
Women in today’s society are busy, career-driven, hardworking professionals. They are focusing on their careers where stress and lack of sleep take priority over their own health. Also, our general population is waiting longer to have children. If you are planning on having children, plan ahead and try to start your family with a healthy mind and within a good age range. Advanced maternal age (AMA) is now considered 35+, just FYI.
5. Blood pressure management
High blood pressure is one of the greatest risk factors for a premature birth. The increased pressure affects blood flow to the placenta and can limit blood supply to the growing fetus. This affects oxygen and essential nutrient delivery, waste removal, etc. and can put the baby in distress. Women with gestational hypertension are considered to be “preeclamptic.” Preeclampsia is a serious condition of pregnancy and is characterized by the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms. My point, go into your pregnancy with knowledge and good management of your blood pressure.
6. Diabetes management
Type I...Type II...and Gestational….Diabetes is Diabetes! And sugar is sugar. Sugar affects a growing fetus in many ways. Babies exposed to high sugar levels can experience breathing difficulties due to immature, poorly inflated lungs, high red blood cell counts (polycythemia), high bilirubin levels, and are at an increased risk for birth defects. I’ve seen firsthand unmanaged diabetes cause congenital heart defects, brain injury, spinal cord malformation, caudal regression syndrome, genetic diseases, GU & GI system disorders, etc. In addition, babies born from a diabetic mother may grow excessively (macrosomic) causing a birth injury or "traumatic birth" (clavicle fracture) and then develop dangerously low sugar levels after birth (hypoglycemia). Why? Because after birth, babies are no longer supplied with the high sugars levels provided by the mother (they are “cut off” from their dealer). Therefore, the baby continues to produce a high insulin level without actually needing it due to the removal from the high glucose environment he/she was in. This high insulin results in the newborn's blood glucose level dropping significantly. This can become very dangerous and toxic to the baby because sugar (glucose) is one of the most essential nutrients that the brain needs for rapid growth and development. If the level drops critically low, this can lead to severe brain damage.
7. Quit smoking and/or drinking
Also an obvious one.
8. Healthy mindset!!!
I cannot begin to stress this one enough. One of the best things you can do for your baby is develop a healthy mindset. This means limiting stress as much as possible. I know, I know… it’s easier said than done. Don’t think about the “what ifs” and what could go wrong during your pregnancy. If you struggle with anxiety or depression, seek help prior to becoming pregnant and make sure you have a good support system after delivery. A healthy mind set will truly help you and your baby in every way possible and will help to minimize fluctuations in hormones, emotions, and chemical imbalances.
8. Educate yourself
Learn the warning signs of preterm labor and seek medical attention for ANY warning signs or symptoms. These include contractions that make your belly tighten every 10 minutes or less, changes in color of your vaginal discharge, vaginal bleeding, fluid leak, low dull back ache, cramps that feel like your period, or belly cramps with or without diarrhea.
9. Communicate with your healthcare provider
Regular check ups are keys to a successful, happy, healthy pregnancy. Communicate openly about your current health status, family history of preterm birth, and develop a rapport with your doc.
10. Relax
As stated earlier, we live in a fast-paced, high-stress world. Stress can put a negative affect on your body, mental health, and your baby. Listen to what your body is telling you! Getting off your feet may be necessary during this time. If you need to put your feet up and take a load off, be mindful of that.
11. Minimize traveling during pregnancy
I cannot tell you how common it is for moms to go into preterm labor while vacationing with her hubby before the baby arrives. I have personally cared for MANY babies whose parents were traveling out of state (and country) and experienced preterm labor shortly after they landed. These poor families typically have NO knowledge about resources available, NO family support locally, and are ridiculously far away from their hometowns. All I’m saying is, plan ahead. Be upfront and ask your doctor if it’s safe to travel. REALLY think long and hard about the risks and benefits associated with the “trip” you’re wanting to take. Is it worth the possibility of potentially delivering out-of-state or in a foreign country?
12. Ethnicity & race consideration
We are unsure why, but some races, ethnicities, and various populations/regions are at increased risk for a premature birth. In general African American and Hispanic races are more prone to premature birth. Whether it is accessibility to healthcare, lifestyle, genetic components, or mistrust in the healthcare system, these populations are at higher risk and statistically have a higher rate of premature births. However, preterm birth is truly a global problem.
13. MOST IMPORTANTLY! Do your research!
No one plans to have a premature baby. But, it does happen! >80% of preterm births are unanticipated, and as many as 11.4% of all pregnancies result in early deliveries. About 1 in 10 babies around the world are too born early. In my opinion, knowledge is power! Come up with a general plan and talk to your healthcare profession regarding what to do and where to go IF you were to deliver early.